83R6893 MCK-D
By: Strama H.B. No. 1143
A BILL TO BE ENTITLED
AN ACT
relating to certain mental health and medical services for children
in foster care and the conservatorship of the state, including the
administration of psychotropic drugs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 266.001, Family Code, is amended by
adding Subdivisions (6) and (7) to read as follows:
(6) "Mental illness" has the meaning assigned by
Section 571.003, Health and Safety Code.
(7) "Psychotropic drug" has the meaning assigned by
Section 261.111.
SECTION 2. The heading to Section 266.005, Family Code, is
amended to read as follows:
Sec. 266.005. PARENTAL NOTIFICATION OF CERTAIN
[SIGNIFICANT] MEDICAL CONDITIONS OR ENROLLMENT OR PARTICIPATION IN
DRUG RESEARCH PROGRAM.
SECTION 3. Section 266.005(b), Family Code, is amended to
read as follows:
(b) Except as provided by Subsection (c), the department
shall make reasonable efforts to notify the child's parents within
24 hours of:
(1) a significant medical condition involving a foster
child; [and]
(2) the enrollment or participation of a foster child
in a drug research program under Section 266.0041;
(3) the diagnosis of a foster child with a mental
illness; or
(4) the prescription of a psychotropic drug for a
foster child.
SECTION 4. Subchapter A, Chapter 266, Family Code, is
amended by adding Sections 266.011, 266.012, 266.013, 266.014, and
266.015 to read as follows:
Sec. 266.011. PRIOR AUTHORIZATION FOR CERTAIN PSYCHOTROPIC
DRUGS. The executive commissioner shall adopt rules requiring
prior authorization from the STAR Health Medicaid managed care
program before a psychotropic drug prescribed for a foster child
may be dispensed. The rules must:
(1) prohibit a pharmacy from dispensing a psychotropic
drug prescribed for a foster child until the pharmacy receives
prior authorization from the STAR Health Medicaid managed care
program for the prescribed psychotropic drug if the prescription is
for:
(A) four or more psychotropic drugs to be taken
concurrently;
(B) two or more psychotropic drugs of the same
class to be taken concurrently;
(C) a psychotropic drug prescribed for a child
younger than five years of age; or
(D) a psychotropic drug the commission
determines should be reviewed; and
(2) require the STAR Health Medicaid managed care
program to respond to a request for authorization required under
Subdivision (1) not later than 24 hours after receiving the
request.
Sec. 266.012. MEDICAL REPORT FOR PRESCRIPTION OF
PSYCHOTROPIC DRUG. (a) The commission, in conjunction with the
department, and with the assistance of appropriate health and human
services agencies, community partners, and physicians and other
health care providers, shall develop a form to report the
prescription of a psychotropic drug to a foster child.
(b) The foster child's physician shall use the form
described by Subsection (a) to report the prescription of a
psychotropic drug to a foster child or a change in the dosage of a
psychotropic drug prescribed for the child and shall update the
report as appropriate to document the child's progress in reaching
the child's treatment goals.
(c) The executive commissioner shall adopt rules specifying
the information required to be included in the report. The report
must include:
(1) the child's diagnosis and a description of the
symptoms and behaviors for which the physician is prescribing the
psychotropic drug;
(2) any possible side effects of the psychotropic drug
that the child's care provider should monitor;
(3) a description of generally accepted alternatives
to the psychotropic drug, if any, and the reasons why the physician
believes that the alternatives are not appropriate;
(4) a description of clearly defined target symptoms
and treatment goals based on recognized clinical rating scales or
other measures to quantify the child's progress toward the
treatment goals;
(5) other information that the physician considers
appropriate, including the child's height, weight, blood pressure,
and laboratory results; and
(6) if the child has been taking the psychotropic drug
for longer than six months, the physician's analysis of the
necessity of continuing the psychotropic drug.
(d) The physician and the person authorized to consent to
medical care for the foster child under this chapter must review and
sign the medical report.
(e) The department shall make the medical report available
as part of the child's health passport described by Section
266.006.
Sec. 266.013. COMPREHENSIVE ASSESSMENTS. Not later than
the 30th day after the date a child enters the conservatorship of
the department, the child shall receive a comprehensive,
multidisciplinary assessment that includes a screening for trauma.
Sec. 266.014. ASSESSMENT REQUIRED BEFORE PRESCRIBING
PSYCHOTROPIC DRUG. Except for authorizing a refill of an existing
prescription or in an emergency that requires the urgent
administration of a psychotropic drug, a physician may not
prescribe a psychotropic drug for a foster child until the
assessment described by Section 266.013 is complete.
Sec. 266.015. STUDY REGARDING USE OF PSYCHOTROPIC DRUGS;
REPORT. (a) The department shall review the use of psychotropic
drugs in the treatment of foster children.
(b) Not later than December 1 of each even-numbered year,
the department shall deliver a report on the review conducted under
Subsection (a), including an analysis of any trends in the use of
psychotropic drugs in the treatment of foster children, to the
governor, the lieutenant governor, and the speaker of the house of
representatives.
SECTION 5. Section 533.0161(b), Government Code, is amended
to read as follows:
(b) The commission shall implement a system under which the
commission will use Medicaid prescription drug data to monitor the
prescribing of psychotropic drugs for [children who are]:
(1) children who are in the conservatorship of the
Department of Family and Protective Services[;] and
[(2)] enrolled in the STAR Health Medicaid managed care
program or eligible for both Medicaid and Medicare; and
(2) children who are under the supervision of the
Department of Family and Protective Services through an agreement
under the Interstate Compact on the Placement of Children under
Subchapter B, Chapter 162, Family Code.
SECTION 6. (a) Except as provided by Subsection (b) of
this section, this Act takes effect September 1, 2013.
(b) Section 266.012, Family Code, as added by this Act,
takes effect February 1, 2014.